sc100 Enthusiasts Club membership application Presented in white for easier printing

Please print, complete and post this form to gain membership of the Club
If you are not able to use this form, please contact Sam Brown (see Club committee).

FOR OFFICE USE ONLY

	Date Payment Received
	Date Payment Banked
WHIZZKID	Date Payment Cleared
	Date Membership Sent Out
SUZUKI sc100 ENTHUSIASTS CLUB	Number of Enclosures

PLEASE USE BLOCK CAPITAL LETTERS

YOUR DETAILS

Full Name
Address
					Post Code
Telephone
Occupation

CAR DETAILS

In order to compile the register of cars, the following details are requested.

Year		Model		Mileage
Engine No.		Registration No.		Body No.
Colour		Condition

Is the car on the road........Y/N

History of Car If Known
Any other useful Information
Modified or Standard
Any other Classic Vehicles owned

I hereby apply for membership and enclose payment (for annual membership) of £15.00

Signed____________________________________Date____________________

Please send Cheque or Postal Order, Payable to 'Suzuki sc100 Enthusiasts Club'.

Please sign this form and return to Samantha Brown, Secretary:

Suzuki sc100 Enthusiasts Club, 57 Wordsworth Mead, St. Anne's Drive, Redhill, Surrey. RH1 1AH

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5 September 2000